ABSTRACT
Endoscopic findings of celiac disease have high specificity and sensitivity. We evaluated records of 137 consecutive patients who had endotherapy for variceal hemorrhage, and who had features of celiac disease at endoscopy; patients who had such markers at endoscopy had undergone duodenal histology and serology. Thirty-one patients had changes of portal hypertensive vasculopathy in the duodenum, 8 had scalloping, and 6 had mosaic pattern; 3 patients also had decreased fold height or sparse folds in the descending duodenum. Six of these 8 patients had positive serology and histology suggestive of celiac disease. Endoscopic evaluation resulted in diagnosis of CD in 4.37% patients of chronic liver disease undergoing endotherapy.
Subject(s)
Celiac Disease/complications , Celiac Disease/pathology , Liver Diseases/complications , Adult , Aged , Biomarkers/blood , Celiac Disease/blood , Chronic Disease , Endoscopy, Gastrointestinal , Female , Humans , Male , Middle Aged , Young AdultABSTRACT
We here report a case of celiac disease and Budd Chiari syndrome. This 19-year-old boy was diagnosed to have portal hypertension in another hospital when he had developed variceal bleeding. In our hospital, he was found to have occlusion of all three hepatic veins as the cause of portal hypertension. On a routine endoscopy, he was found to have scalloping of duodenal folds. Suspecting celiac disease, he was investigated further. He did have positive serology for celiac disease as well as suggestive histology. He was found to be deficient for protein C and protein S. He was managed conservatively and put on gluten-free diet, with which he showed clinical improvement. A review of literature showed that only 14 previous cases of this combination were recorded and except for one all were from North Africa or southern Europe.
Subject(s)
Budd-Chiari Syndrome/diagnosis , Celiac Disease/diagnosis , Hypertension, Portal/diagnosis , Budd-Chiari Syndrome/complications , Celiac Disease/complications , Diet, Gluten-Free , Humans , Hypertension, Portal/etiology , Male , Protein C Deficiency/diagnosis , Protein S Deficiency/diagnosis , Treatment Outcome , Young AdultABSTRACT
Pancreatic Neuroendocrine tumors (PNET) are rare tumors that require a high degree of suspicion for timely diagnosis. They are best divided into functional and nonfunctional varieties. Functional tumors often are symptom specific and are diagnosed at an earlier stage than nonfunctional tumors. The severity of symptoms and pace of disease should dictate therapy. Surgical extirpation remains the only curative modality for localized disease, but palliation of hormone-related symptoms can be achieved with different modalities (Management of hormonal Excess, biologic therapy, chemotherapy and biochemotherapy, local-regional therapy with hepatic arterial embolization).
